The FDA approval in summer 2006 of an efficacious human papillomavirus (HPV) vaccine provides an unprecedented opportunity for the primary prevention of cervical cancer. However, little is known about how to effectively deliver this vaccine to those most likely to benefit from its use: medically underserved pre- adolescent females. To translate this breakthrough into reduced cervical cancer incidence rates in the underserved, we must first take steps to enhance the likelihood that medically underserved teen and preteen females receive the HPV vaccine. The objective of this proposal is to gain information to develop effective educational interventions and then develop the intervention. To achieve this objective, we propose to address the following specific aims: 1) To conduct formative, qualitative research to identify factors that act as barriers to vaccines in general and to HPV vaccination in particular in medically underserved communities, especially among parents and pre- adolescent and early adolescent females. 2) To plan and develop an educational intervention to enhance informed decision-making in underserved communities concerning HPV vaccine delivery to pre-adolescent/early adolescent females. Using focus group methodology, we will characterize similarities and differences in perception of HPV vaccination in multiple groups of African Americans, Latinos, and white Americans. Focus groups will be conducted among both adult community stakeholders and pre-adolescent/adolescent females to assess inter- generational differences in perceptions. Comparisons of results between racial/ethnic groups will allow us to determine the value of tailoring subsequent interventions. This project addresses a timely, novel research topic that is translational by disseminating a scientific breakthrough to the general population to advance the public's health. This work will be carried out by a highly-qualified interdisciplinary research team, will address racial/ethnic disparities in the burden of cervical cancer, and will form the basis for a subsequent R01 to test interventions that will ultimately contribute to a U.S. model for cervical cancer control. The quadrivalent human papillomavirus (HPV) vaccine has been shown to virtually prevent 70% of cervical cancers when given to preteen girls. Information about the vaccine and its utilization are critical components in making the prevention of cervical cancer a reality. Understanding barriers and misperceptions that underserved communities have concerning the vaccine and cervical cancer will enable researchers to develop and test educational interventions that are ethnically and culturally effective and that ultimately enable vaccine acceptance. [unreadable] [unreadable] [unreadable]